Table 3 Recommendation for the management of biphasic dyskinesias

① Replace controlled-release levodopa with immediate-release levodopa, preferably with madopar dispersible, which can be used to manage the beginning-of-dose dyskinesia.

② Add long half-life dopamine agonists or COMT inhibitors, which can extend the half-life of plasma levodopa, thus increasing the area under the curve, and relieving the end-of-dose dyskinesia. This may also benefit the beginning-of-dose dyskinesia.